Comparative Evaluation of Metabolic Syndrome in Premenopausal and Postmenopausal Women

Background:The prevalence of the Metabolic Syndrome is increasing tremendously due to increase in obesity around the World. Metabolic Syndrome doubles the risk of Atherosclerotic Cardiovascular diseases and approximately four fold increases the risk of developing type II diabetes mellitus. It has been seen that Metabolic Syndrome is on the rising trend especially in post-menopausal women. Metabolic Syndrome is widely increasing especially in the transition phase in every woman’s life from premenopausal to menopausal phase. The aim of this study is to compare presence of metabolic syndrome and its components in premenopausal and post-menopausal women. Material and Methods: The study was conducted in 300 pre-menopausal and 300 postmenopausal women attending Medicine OPD and admitted in ward of Dr. B.R.A.M. Hospital, Raipur C.G. from March 2015 to August 2016.The objective of the study was explained and informed to women and data of each women was recorded in identical pre designed proforma after informed and written consent. Participants were categorized into two groups Pre-menopausal age group and Post-menopausal age group. Investigations including Fasting blood sugar, Lipid Profile and Anthropometric measurements including height, weight, waist circumference (WC) and hip circumference (HC) was recorded. A modified definition by the Adult Treatment Panel III guideline of the National Cholesterol Education Program was used to categorize the subjects according to presence of metabolic syndrome. Results: In the present study the mean age of pre-menopausal and postmenopausal group was 42.8 yrs and 54.5 yrs respectively in a study group of 300 women in each. The mean age of attaining menopause in present study was 46 ± 3.1 yrs. Mean systolic BP in pre-menopausal and post-menopausal study group was 117.13±10.87mmHg and 118.23+13.15mmHg respectively. Mean Diastolic BP in pre-menopausal and postmenopausal study group was 78.55 ± 8.19mmHg and 77.70+9.24mmHg respectively. No significant difference was observed between two groups regarding systolic BP (p=0.265) and diastolic BP. (p=0.234) The mean Waist Circumference (WC) was 78.96 ± 8.84 cms and 80.11±10.82 cms in pre and post menopausal group respectively with no significant difference. Waist Hip Ratio was found to be significantly higher in postmenopausal subjects compare to pre-menopausal subjects.(p=0.001). BMI was was found to be significantly higher in post-menopausal subjects as compared to pre-menopausal subjects.(p=0.003). TG was found to be significantly higher in Postmenopausal subjects compared to pre -menopausal subjects (p<0.0001). HDL was found to be significantly lower in Post-menopausal subjects compared to premenopausal subjects (p=0.071).FBS and PPBS were found to be significantly higher in Postmenopausal subjects as compared to pre-menopausal subjects. Raised FBS levels in post-menopausal subjects was statistically significant (p<0.0001) in the study. The overall prevalence of Metabolic Syndrome as per NCEP ATP III and IDF criteria was 38% and 50.7%. respectively in our study. The prevalence of Metabolic Syndrome in post-menopausal women as per NCEP ATP III and IDF criteria was 48.6% and 56.8% respectively. Prevalence of Metabolic Syndrome in pre-menopausal women as per NCEP ATP III criteria is 27.4%. and 44.6% as per IDF criteria. In pre-menopausal group – Among this study subjects 1.47% had five risk factors of Metabolic Syndrome, 15.3%had four, 10.43%had three, 45.9% had two risk factors while 26.9% had only one risk factor of Metabolic Syndrome. In post-menopausal group 10.2% had five risk factors of Metabolic Syndrome and 40.32%had four risk factors while 49.4%had three and50.9% had two and 36.9%had one risk factor of Metabolic Syndrome in the study. Conclusion: In present study there was high prevalence of Metabolic Syndrome (48.6%) among postmenopausal women than pre-menopausal women (27.4%) The incidence of Metabolic Syndrome increases with age , peak is seen in fourth to sixth decade. Dyslipidemia and abdominal obesity were the most prevalent components of Metabolic Syndrome among these women.